Background: Patients with varied demographic characteristics, admission criteria and heterogeneous group are admitted to medical Intensive Care Unit (ICU) and are usually associated with co-morbid illnesses. Instituting rational pharmacotherapy is the need of the hour for saving the life of critically-ill patients while irrational drug use may be life threatening. Drug use patterns and prescribing behaviour are the essential tools to measure drug use in health care facilities.Methods: A record based, cross-sectional, observational study was done at medical ICU, IGMC and RI, Puducherry after obtaining IEC approval. Systemic random sampling was followed and data was collected for a period of one year. Data were analysed based on demographic characteristics, prescribing pattern and WHO drug use indicators.Results: The data of 151 patients were analysed. Mean age of the patients admitted in ICU was 52.9±17.7 years. Percentage of male patients (57.6) admitted in ICU were more when compared to female patients (42.4). Infective etiology was the most common factor for ICU admission followed by cardiac disorders. Diabetes mellitus and hypertension were the most common co-morbidities. The average length of stay in ICU was 4.11±2.99 days. Duration of stay in ICU ranged from 1-5 days (78.8% patients) to 15-20 days (0.1% patients). On an average 10.6±4.3 drugs were prescribed for each patient. Percentage of drugs prescribed by generic name was 45.8%. Majority of the drugs (87.4%) were from essential medicine list. Antibiotics in the prescription was 13.8% and 44.4% of drugs were administered in parenteral route. The prescription was complete in 145 case sheets (96%). Majority of the patients (68.9%) were discharged with improvement in the condition for which they were admitted.Conclusions: This drug utilization study has highlighted the strengths and shortcomings of the prescription pattern of patients who were admitted in the critical care setup. The information derived from this research work will be transmitted to the stakeholders for implementing the modifications wherever applicable for the betterment of the patient and the community.

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Fluoroquinolones are the commonly used antimicrobials in the treatment of urinary tract infection, bacterial diarrhea, and infections of soft tissue, bone, and joints. They may cause adverse effects ranging from gastrointestinal disturbances, headache, insomnia, and cutaneous reactions. Their rare adverse effects include phototoxicity, cardiotoxicity, arthropathy, and tendinitis. Among the fluoroquinolones, levofloxacin has more propensity to cause the central nervous system adverse effects such as headache, tremor, insomnia, dizziness, convulsions, psychosis, auditory, and visual hallucinations. A case of acute sinusitis in a young male treated with levofloxacin presented with tactile hallucination and acute anxiety reaction is reported for its rarity of occurrence. According to the Naranjo causality scale, the association of tactile hallucination and acute anxiety is a probable adverse drug reaction due to levofloxacin.

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Background: Nephrotic syndrome is a common illness affecting the paediatric age group and 80% of the idiopathic syndrome is steroid sensitive. Multiple relapses make them vulnerable to the adverse effects of corticosteroids. There is limited literature evidence for the adverse effects of steroids in children with renal pathology.Methods: This descriptive, cross sectional study analyses the adverse effects of oral prednisolone in children and adults with nephrotic syndrome Fifty-five patients with nephrotic syndrome, attending nephrology or paediatric OP, more than 3 years of age and who were on oral prednisolone for a minimum of eight weeks were included in the study. Demographic details, detailed history, lab investigations and ophthalmic examination were done and the results were analysed.Results: Hypertension and behavioural changes were the most common adverse effects followed by dermatological, endocrine and metabolic changes. Infections and gastrointestinal disturbances were more in adults (p <0.05). Short stature was more in children (p< 0.05). There was no abnormality in blood glucose levels and body weight. Hypertension, cushingoid habitus, infections and short stature were statistically less in patients on alternate day prednisolone. But no statistical association could be made between the occurrence of cataract and the pattern of prednisolone use.Conclusions: Adverse effects pattern is different among adults and children. Also, the adverse effects are less with alternate day prednisolone regimen. Long term follow up into their adulthood is needed to analyse the morbidity produced by corticosteroids in these subsets of population.